Nateglinide superior to glyburide in controlling postprandial hyperglycemia
Postprandial plasma glucose is believed to be a more reliable indicator of glycemic control and cardiovascular morbidity than fasting plasma glucose . Nateglinide is a drug that acts rapidly in controlling postprandial spikes in glucose levels. The efficacy and safety of nateglinide taken at mealtimes in controlling PPG excursions was evaluated in a randomized, double-blind, controlled trial with low-dose glyburide as active comparator. Subjects with type 2 diabetes randomly received either nateglinide 120 mg three times a day or glyburide 5 mg once daily for 6 weeks. Primary outcome was baseline-adjusted change in FPG to 2-hour PPG. Safety surveillance included adverse events monitoring especially hypoglycemia episodes. Reductions in 1-hour and 2-hour PPG spikes were significantly greater in the nateglinide versus the glyburide group . Incidence of hypoglycemia was 10% in the natiglinide group, which is significantly lower than in the comparator group . Overall AE incidences were 22 and 26% in the natiglinide and glyburide groups, respectively. The study demonstrated that nateglinide has a better efficacy and safety profile compared to glyburide in controlling glucose excursions after a meal in patients with type 2 diabetes : 560).
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